Pchelina Polina, Duss Simone B, Bernasconi Corrado, Berger Thomas, Krieger Tobias, Bassetti Claudio L A, Urech Antoine
Department of Neurology and Neurosurgery, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia.
Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Diagnostics (Basel). 2023 Feb 19;13(4):781. doi: 10.3390/diagnostics13040781.
Understanding which factors predict the outcome of internet-based cognitive behavioral therapy for insomnia (iCBT-I) may help to tailor this intervention to the patient's needs. We have conducted a secondary analysis of a randomized, controlled trial comparing a multicomponent iCBT-I (MCT) and an online sleep restriction therapy (SRT) for 83 chronic insomnia patients. The difference in the Insomnia Severity Index from pre- to post-treatment and from pre-treatment to follow-up at 6 months after treatment was the dependent variable. Prognostic and treatment-predictive factors assessed at baseline were analyzed with multiple linear regression. The shorter duration of insomnia, female gender, high health-related quality of life, and the higher total number of clicks had prognostic value for a better outcome. Other factors were found to be prognostic for outcome at the follow-up assessment: treatment with benzodiazepines, sleep quality, and personal significance of sleep problems. A high level of dysfunctional beliefs and attitudes about sleep (DBAS) was a moderator for better effects in the MCT at post-treatment assessment. Various prognostic factors (e.g., duration of insomnia, gender, or quality of life) may influence the success of treatment. The DBAS scale may be recommended to select patients for MCT rather than SRT.
了解哪些因素可预测基于互联网的失眠认知行为疗法（iCBT-I）的治疗效果，可能有助于根据患者需求调整这种干预措施。我们对一项随机对照试验进行了二次分析，该试验比较了多成分iCBT-I（MCT）和在线睡眠限制疗法（SRT）对83名慢性失眠患者的治疗效果。治疗前至治疗后以及治疗后6个月随访时失眠严重程度指数的差异为因变量。采用多元线性回归分析基线时评估的预后因素和治疗预测因素。失眠持续时间较短、女性、较高的健康相关生活质量以及较高的点击总数对更好的治疗效果具有预后价值。在随访评估中发现其他因素对治疗效果具有预后意义：使用苯二氮䓬类药物治疗、睡眠质量以及睡眠问题的个人重要性。在治疗后评估中，对睡眠的功能失调信念和态度水平较高（DBAS）是MCT治疗效果更好的调节因素。各种预后因素（如失眠持续时间、性别或生活质量）可能会影响治疗的成功。可能建议使用DBAS量表来选择接受MCT而非SRT治疗的患者。
